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Health & Welfare SPD Design Element

C. DEPENDENT ELIGIBILITY RULES

1. Dependent Defined.

“Dependent” means your lawful spouse, your Domestic Partner as defined below, and your unmarried dependent child under 19 years of age, an unmarried child who has attained age 19 but who has not reached his or her 25th birthday if he or she is dependent on you for support and is attending an accredited trade school, college or university as a full-time student as defined by the educational institution.

  1. Child Defined. “Child” includes your natural child, stepchild, legally adopted child, foster child, your Domestic Partner’s child or other child provided such child is dependent upon you for support and maintenance and is part of your household, or a child for whom you have been appointed legal guardian or are required to provide dependent coverage pursuant to a Qualified Medical Child Support Order (“QMCSO”). (See paragraph 4, below, for a description of a QMCSO.)

    Summer months are covered provided the Dependent was a full-time student the previous Spring semester or quarter. You are required to provide proof of full-time student status each quarter or semester, whichever is applicable.

  2. Domestic Partner Defined. “Domestic Partner” is defined as a spousal equivalent relationship sanctioned by the laws of a state, county, city or other municipality. Domestic Partners shall become eligible on the first day of the month following the month the Plan Office receives proof of Domestic Partner status in the form of an official certification of registration of domestic partnership and either (1) an affidavit of “dependency” for tax purposes, or (2) advance remittance of at least six months of taxes the Plan Office determines are due on the additional imputed taxable income to the member, including the employer’s portion of such taxes. The Plan will not be responsible for any taxes, tax-related penalties or interest imposed on the member as a result of providing Domestic Partner coverage.

2. Disabled Dependent Child Age 19 through 24.

Your dependent child whose coverage would otherwise terminate solely due to attainment of the limiting age may continue to be considered a Dependent while he or she is incapable of self-sustaining employment by reason of mental or physical disability, provided written evidence of such incapacity is furnished to the Plan Office with respect to that child by the thirty-first day after the later of (a) the attainment of such age, or (b) the date you become aware of your child’s incapacity. Proof of the continued existence of such incapacity must be furnished to the Plan Office from time to time at the Plan’s request. The Board may require that your child see a Physician or other specialist selected by the Plan.

3. Dependent Coverage upon Death of Member.

Upon your death, your surviving spouse and Dependents will be eligible for benefits until your hour bank reserve is exhausted. Thereafter, if you died while you were an Active member or Early Retiree, your Dependents (other than a Domestic Partner or the children of a Domestic Partner) will be eligible for Retiree coverage if, regardless of your age at the date of death, you would have met the Active member coverage requirements for Retiree membership eligibility set forth in B. If you died while you were a Regular Retiree, your Dependents will remain eligible for Retiree member Dependent coverage in the Plan upon your death.

In all cases, surviving spouse coverage will cease upon a remarriage. If the requirements under B.6 Monthly Charge for Retiree Coverage, above, are not satisfied, Dependents (other than Domestic Partners or children of Domestic Partners) are eligible for enrollment in COBRA or the standard conversion plan, if any. If you have no Dependents at the date of your death, your successors shall have no claim for coverage, payments, or refunds.

4. Qualified Medical Child Support Order (“QMCSO”).

You must provide written proof of legal dependent status such as a birth certificate for a child, a decree of adoption for an adopted child and a marriage certificate for a spouse. You must furnish the Plan Office with a copy of a court order for any child who has been appointed to your care pursuant to a court-ordered guardianship or QMCSO. A copy of the Plan's QMCSO procedures may be obtained from the Plan Office without charge. A QMCSO recognizes an eligible child's right to receive Plan benefits as a beneficiary of an eligible Plan Participant. The child, to be covered by the benefits of this Plan, must be a Dependent as defined in the Plan.

The steps that will be followed to establish and determine the qualified status of a QMCSO are:

  1. You must provide the Plan Office a copy of your QMCSO.

  2. Within thirty (30) days after receipt of the QMCSO, the Plan Office will notify you and the Dependent (through his or her custodial parent, guardian or representative), in writing, if the QMCSO is acceptable to the Plan.

  3. If the Plan determines that the Court order does not constitute a QMCSO, or additional information is required, you and the Dependent (through his or her custodial parent, guardian or representative) will be notified in writing by the Plan or the Plan's legal counsel.
    1. If the QMCSO is denied, the notice shall describe the reasons for this decision. There is a right to appeal a denial, and the summary of the Plan's appeals procedures will be included in the notice of denial.
    2. If additional information is required, notification will be provided as to what is needed, and you will have sixty (60) days to respond. If you do not respond within sixty (60) days, the request for the QMCSO will be deemed canceled.

      You will be required to certify under penalty of perjury that the dependent child meets these requirements.

5. Proof of Continued Dependent Status.

You are required to notify the Plan immediately if any individual ceases to be your Dependent. Proof of the continued existence of Dependent status must be furnished to the Plan Office from time to time at the Plan’s request.